ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesI50.84

I50.84

Billable

End stage heart failure

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I50.84 is a billable code used to indicate a diagnosis of end stage heart failure.

Key Diagnostic Point:

End stage heart failure (I50.84) represents the final phase of heart failure, where the heart's ability to pump blood effectively is severely compromised, leading to significant clinical symptoms and a high risk of mortality. Patients may present with profound fatigue, dyspnea at rest, and fluid retention, resulting in edema and ascites. The anatomy involved primarily includes the heart, particularly the left ventricle, which is often dilated and poorly functioning. Disease progression typically follows a chronic course, with patients experiencing acute exacerbations and gradual decline in functional capacity. Diagnostic considerations include echocardiography to assess ejection fraction, BNP levels to evaluate heart failure severity, and clinical assessments to monitor symptoms and response to treatment. Management may involve advanced therapies such as mechanical circulatory support or heart transplantation, highlighting the critical nature of this condition and the need for comprehensive care planning.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation of heart function and symptomatology.
  • Treatment complexity: Involves advanced interventions and multidisciplinary care.
  • Documentation requirements: Necessitates detailed clinical notes and evidence of end-stage status.
  • Coding specificity: Requires precise coding to differentiate from other heart failure stages.

Audit Risk Factors

  • Common coding errors: Misclassification with less severe heart failure codes.
  • Documentation gaps: Incomplete clinical notes regarding symptom severity and treatment history.
  • Billing challenges: Potential denials due to lack of clear evidence of end-stage status.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

End-stage heart failure significantly impacts population health, contributing to high rates of hospitalization and healthcare utilization. It is associated with increased morbidity and mortality, necessitating comprehensive management strategies to improve quality of life. Quality measures focus on timely interventions and patient education to optimize care. Epidemiologically, the prevalence of heart failure is rising, highlighting the need for effective management and resource allocation in healthcare systems.

ICD-9 vs ICD-10

End-stage heart failure significantly impacts population health, contributing to high rates of hospitalization and healthcare utilization. It is associated with increased morbidity and mortality, necessitating comprehensive management strategies to improve quality of life. Quality measures focus on timely interventions and patient education to optimize care. Epidemiologically, the prevalence of heart failure is rising, highlighting the need for effective management and resource allocation in healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations include the use of appropriate modifiers for advanced therapies and ensuring that documentation supports the medical necessity of services rendered. Common denials may arise from insufficient evidence of end-stage status or lack of detailed clinical notes. Best practices include maintaining thorough records of patient assessments, treatment responses, and consultations with specialists to substantiate claims.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I50.84?

I50.84 specifically covers patients diagnosed with end-stage heart failure, characterized by severe symptoms and significant limitations in daily activities. This includes patients requiring advanced therapies such as inotropes, mechanical support, or those awaiting heart transplantation.

When should I50.84 be used instead of related codes?

I50.84 should be used when a patient exhibits clear signs of end-stage heart failure, such as persistent symptoms despite optimal medical therapy, significant functional impairment, or when advanced interventions are being considered.

What documentation supports I50.84?

Documentation should include a comprehensive assessment of the patient's heart function, symptom severity, treatment history, and any referrals for advanced therapies. Clinical notes should clearly indicate the patient's status as end-stage heart failure.